This article argues that correctional institutions violate the Eighth Amendment when they refuse to establish MAT programs and prevent doctors from exercising medical judgment to properly treat incarcerated people with OUD.

In an age characterised by an increasing integration of advanced technology into our everyday lives, posthumanism has developed into a major intellectual force. It affects research agendas, economic developments, social policies, philosophical theories, and ultimately the way we understand ourselves. This handbook provides a comprehensive overview of the various aspects of posthumanism and how they are represented, discussed and exemplified in the cultural medium of film and television. Understood broadly as any critical engagement with the possibility that the human condition (...) is no longer a given, that it is more fluid than we once thought, and that we are, or will soon be, free to remould our constitutive framework and value systems, posthumanism is the next step in critical engagement in the humanities. It reflects upon the malleability of the human condition and acknowledges the fact that we are no longer the beings we thought we were, and that perhaps we never were. (shrink)

Freedom of speech, press, assembly, and petition have long been celebrated as crucial to democratic government. United States Supreme Court decisions have, quite rightly, justified strong protection of these freedoms because of their crucial role in the functioning of American democracy.

Agricultural industries in developed countries may need to consider transformative change if they are to respond effectively to contemporary challenges, including a changing climate. In this paper we apply a resilience lens to analyze a deliberate attempt by Australian governments to restructure the dairy industry, and then utilize this analysis to assess the usefulness of resilience thinking for contemporary agricultural transformations. Our analysis draws on findings from a case study of market deregulation in the subtropical dairy industry. Semi-structured interviews were (...) conducted with dairy producers, their service providers, and industry and government staff. We found the adaptive cycle concept contributed to understanding how deregulation changed industry structures and working practices, how those changes led to feedbacks within the production system and supply chain, and how the industry following deregulation has experienced periods of stability and instability. Regime shifts were associated with an increase in demand for human capital, a degradation of cognitive social capital and a reduction in farm income. Findings identified that were not readily explained by the resilience thinking conceptual framework include a producer’s ability to anticipate and make choices and the change in social and power relationships in the industry. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

BackgroundThe biopharmaceutical industry operates at the intersection of life sciences, clinical research, clinical care, public health, and business, which presents distinct operational and ethical challenges. This setting merits focused bioethics consideration to complement legal compliance and business ethics efforts. However, bioethics as applied to a biopharmaceutical industry setting often is construed either too broadly or too narrowly with little examination of its proper scope.Main textAny institution with a scientific or healthcare mission should engage bioethics norms to navigate ethical issues that (...) arise from the conduct of biomedical research, delivery of clinical care, or implementation of public health programs. It is reasonable to assume that while bioethics norms must remain constant, their application will vary depending on the characteristics of a given setting. Context “specification” substantively refines ethics norms for a particular discipline or setting and is an expected, needed and progressive ethical activity. In order for this activity to be meaningful, the scope for bioethics application and the relevant contextual factors of the setting need to be delineated and appreciated. This paper defines biopharmaceutical bioethics as: the application of bioethics norms (concepts, principles, and rules) to the research, development, supply, commercialization, and clinical use of biopharmaceutical healthcare products. It provides commentary on this definition, and presents five contextual factors that need to be considered when applying bioethics norms to a biopharmaceutical industry setting: (1) dual missions; (2) timely and pragmatic guidance; (3) resource stewardship; (4) multiple stakeholders; and (5) operational complexity.ConclusionUnderstanding the scope of the biopharmaceutical enterprise and contextual factors of a biopharmaceutical industry setting is foundational for the application of bioethics norms. Establishing a common language and approach for biopharmaceutical bioethics will facilitate breadth and depth of discussion and subsequent implementation to benefit patients, the healthcare system and society. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 51-52 [Access article in PDF] Congress Considers Incentives for Organ Procurement Alexander S. Curtis [Tables]During the 108th Congressional session, several bills pertaining to ethical incentives for organ donation likely will be introduced. In some cases, they will be similar to bills before the 107th Congress (see Table 1). Bills in both the House of Representatives and the Senate address the establishment (...) and maintenance of donor registries, financial reimbursements for medical and nonmedical expenses incurred by qualifying donors, the presentation of commemorative medals, and tax credits.A bill entitled "Gift of Life Congressional Medal Act" (introduced last year by Senate majority leader Bill Frist (R-TN) as Senate Bill 325), and its corresponding bill of the same title (passed in the House of Representatives last year as H.R. 708), would establish a congressional commemorative medal honoring "any organ donor, or the family or family member of any organ donor." The medal is to be designed and struck with "suitable emblems, devices, and inscriptions" by the Secretary of the Treasury. The eligible donor or donor's family member would be presented with the medal by the Secretary of Health and Human Services. This bill would establish qualifying donations as those of human kidneys, livers, hearts, lungs, pancreases, or any other organ, but excludes corneas and eyes.Another bill, introduced by Representative Michael Bilirakis (R-FL) entitled "Organ Donation Improvement Act" (H.R. 624), would award grants or contracts to states, transplant centers, and qualified organ procurement organizations for the purpose of providing travel, subsistence, and incidental nonmedical expenses to individuals who make living donations. In order to receive reimbursement, the donating individuals must reside in states other than the states in which the intended recipients reside and the annual income of those receiving the organs cannot exceed $35,000. The bill also would appropriate $15,000,000 to make grants to states and public and nonprofit entities for the purpose of carrying out studies, public education demonstrations, and outreach activities "designed to increase the number of organ donors within the state." The bill would be effective from time of enactment through 2005. [End Page 51]Two other bills proposed within the House of Representatives in 2002 called for amendment to the Internal Revenue Code. The "Gift of Life Tax Credit Act (introduced as H.R. 1872 by Representative James Hansen (R-UT)) and the "Help Organ Procurement Expand Act" (introduced as H.R. 2090 by Representative Chris Smith (R-NJ)) present a refundable credit to individuals or to the estates of those who agree either to be living donors or to donate their organs upon death. The "Gift of Life Tax Credit Act" refunds $10,000 to the estates of eligible individuals "for the taxable year which includes the date of the individual's death." The "Help Organ Procurement Expand Act" offers a refund of $2,500 to qualified persons. Donations of kidneys, livers, pancreases, islet cells, lungs, and intestines are accepted, however several conditions restrict permissible donors. The "Gift of Life Tax Credit Act" requires that the legally competent individual's death not be due to a suicide and that the intention to donate was clearly declared. The "Help Organ Procurement Expand Act" prohibits donations from individuals who were killed with physician assistance, died as a result of a suicide, have been indicted or convicted of a felony or a misdemeanor offense, or are actively under criminal investigation for a possible felony offense. The "Help Organ Procurement Expand Act" also restricts procuring organs from unborn children or human fetuses and under circumstances in which the living donor would be subject to "unacceptable levels of medical risk of death or permanent debilitation." Alexander S. Curtis is a research assistant at the Kennedy Institute of Ethics, Georgetown University, Washington, DC. He received his bachelor's degree from Miami University.... (shrink)

This article examines Richard Rorty’s much criticized figure of the ironist, and the role that it plays in liberal society. It argues that, against Rorty’s own presentation, irony might have positive social consequences. It does so by examining Rorty’s description of the ironist, arguing that it contains different ideas which emerge at different points in Contingency, Irony, and Solidarity. It takes up William Curtis’ claim that irony is a civic virtue, one closely associated with liberal ideas such as tolerance (...) and pluralism. Curtis is insightful in identifying this aspect of irony, but I argue that it might also play a further role. The ironist is concerned with self-creation, something which Rorty takes to be a private activity, but I argue that the selves ironists create might potentially benefit liberal society, with the ironist’s redescriptions calling into question received wisdom and alerting us to unnoticed forms of cruelty. (shrink)

Science fiction has served the film industry like a dreamy stepchild. It gets only scant accolades from its master but must do heavy lifting: that is, make money. While science-fiction films often emphasize spectacle and action, they also inspire philosophical contemplation. Why? Science fiction, dating back to Shelley and Verne, came into existence speculating about humanity's social and physical worlds. Many books and articles over the past several years discuss the philosophical issues that films raise. One fairly new school of (...) thought, "posthumanism," explicitly deriving from postmodernism, with touches of critical theory, has seized on science-fiction movies as support for its theorizing. This volume and its 42 authors from film theory, science and technology studies, literary criticism, media studies, and philosophy, offer an array of posthumanist scholarship. (shrink)

According to the received account of guilt in the philosophical literature, one cannot feel guilt unless one takes oneself to have done something morally wrong. But ordinary people feel guilt in many cases in which they do not take themselves to have done anything morally wrong. In this paper, I focus on one kind of guilt without perceived wrongdoing, guilt about being merely causally responsible for a bad state-of-affairs. I go on to present a novel account of guilt that explains (...) guilt about mere causal responsibility, according to which guilt represents part of the self as bound up with what is bad. (shrink)

A number of studies have tested the relationship between a corporation's social and ethical performance and its financial performance. In contrast, this is the first study to demonstrate a link between overall financial performance and an emphasis on ethics as an aspect of corporate governance. It identifies the 26.8 percent of the 500 largest U.S. public corporations that, in their annual report to shareholders, commit to ethical behavior toward their stakeholders or emphasize compliance with their code of conduct. The financial (...) performance of these corporations ranks higher than that of those who do not at a significance level of p = < 0.005, using the 1997 Business Week ranking which averages eight publicly-reported measures of historical financial performance. These findings should motivate more corporations to utilize the principles of Social and Ethical Accounting, Auditing and Reporting (SEAAR). (shrink)

Most scholars think of David Hilbert's program as the most demanding and ideologically motivated attempt to provide a foundation for mathematics, and because they see technical obstacles in the way of realizing the program's goals, they regard it as a failure. Against this view, Curtis Franks argues that Hilbert's deepest and most central insight was that mathematical techniques and practices do not need grounding in any philosophical principles. He weaves together an original historical account, philosophical analysis, and his own (...) development of the meta-mathematics of weak systems of arithmetic to show that the true philosophical significance of Hilbert's program is that it makes the autonomy of mathematics evident. The result is a vision of the early history of modern logic that highlights the rich interaction between its conceptual problems and technical development. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

The confounding effects of heterogeneity in biological psychiatry and psychiatric genetics have been widely discussed in the literature. We suggest an approach in which heterogeneity may be put to use in hypothesis testing, and may find application in evaluation of the Crespi & Badcock (C&B) imprinting hypothesis. Here we consider three potential sources of etiologic subtypes for analysis.

The target article by Charney on behavior genetics/genomics discusses how numerous molecular factors can inform heritability estimations and genetic association studies. These factors find application in the search for genes for behavioral phenotypes, including neuropsychiatric disorders. We elaborate upon how single causal factors can generate multiple phenotypes, and discuss how multiple causal factors may converge on common neurodevelopmental mechanisms.

Our aim in this paper is to present the distinct ways in which Wolff, Baumgarten, and Kant understand the relationship between necessitation, constraint, and reluctant action in an effort to illustrate the subtle ways in which their conceptions of obligation differ from each another. Whereas Wolff conceives of natural or moral obligation as incompatible with constraint, Baumgarten holds that constraint and reluctant action are, in some instances, compatible with natural obligation. Kant departs from Baumgarten by conceiving of obligation as necessarily (...) involving constraint: as Kant’s reply to Schiller’s famous objection reveals, obligation must take on the character of constraint to reluctant action on account of the fact that human beings possess inclinations that always threaten to impel them in directions that oppose morality. (shrink)

What is the relation between small-scale collaborative plans and the execution of those plans within interactive contexts? I argue here that joint attention has a key role in explaining how shared plans and shared intentions are executed in interactive contexts. Within singular action, attention plays the functional role of enabling intentional action to be guided by a prior intention. Within interactive joint action, it is joint attention, I argue, that plays a similar functional role of enabling the agents to act (...) in a collaborative way such that their actions are rationally guided by a prior shared intention. This understanding of joint attention – as having a key functional role of enabling the rational guidance of joint intentional action by a prior shared intention – allows for an alternative understanding of the kind of minimal cooperation that infants can engage in. On this understanding, infants’ capacity to engage in joint actions is already an incipient capacity to engage in rational and intentional joint actions, albeit a capacity that is necessarily scaffolded by an adult rational co-partner. (shrink)

This a clear and concise introduction to Danish philosopher Soren Kierkegaard.ichael Watts uses Kierkegaard's own writings to introduce his theoriesbout living a truthfu; and spiritual life, while explaining the enormousnfluence of the philosopher's personal life on his work and beliefs. As theounder of 20th century existentialism, and the first philosopher to definehe idea of angst, Kierkegaard's profound influence on modern life is clearlyefined in accessible terms in this guide for students and general readers.

Common knowledge is ubiquitous in our lives and yet there remains considerable uncertainty about how to model or understand it. Standard analyses of common knowledge end up being challenged by either regress or circularity which then give rise to well-known paradoxes of practical reasoning, such as the Two Generals’ Paradox. This paper argues that the nature and utility of common knowledge can be illuminated by appeal to Wittgenstein’s Hinge Epistemology. It is argued that those things that we standardly think of (...) as being common knowledge in our lives are the same as those that Wittgenstein identified as hinge certainties. This identification of common knowledge with hinge certainties allows us to resolve the regress problem for common knowledge and explain how the Two Generals’ Paradox arises. (shrink)

Much of the debate about identity in recent decades has been about personal identity, and specifically about personal identity over time, but identity generally, and the identity of things of other kinds, have also attracted attention. Various interrelated problems have been at the centre of discussion, but it is fair to say that recent work has focussed particularly on the following areas: the notion of a criterion of identity; the correct analysis of identity over time, and, in particular, the disagreement (...) between advocates of perdurance and advocates of endurance as analyses of identity over time; the notion of identity across possible worlds and the question of its relevance to the correct analysis of de re modal discourse; the notion of contingent identity; the question of whether the identity relation is, or is similar to, the composition relation; and the notion of vague identity. A radical position, advocated by Peter Geach, is that these debates, as usually conducted, are void for lack of a subject matter: the notion of absolute identity they presuppose has no application; there is only relative identity. Another increasingly popular view is the one advocated by Lewis: although the debates make sense they cannot genuinely be debates about identity, since there are no philosophical problems about identity. Identity is an utterly unproblematic notion. What there are, are genuine problems which can be stated using the language of identity. But since these can be restated without the language of identity they are not problems about identity. (For example, it is a puzzle, an aspect of the so-called “problem of personal identity”, whether the same person can have different bodies at different times. But this is just the puzzle whether a person can have different bodies at different times. So since it can be stated without the language of personal “identity”, it is not a problem about identity, but about personhood.) This article provides an overview of the topics indicated above, some assessment of the debates and suggestions for further reading. (shrink)

It is a commonplace in economics that we should disregard sunk costs. The sunk cost effect might be widespread, goes the conventional wisdom, but we would be better off if we could rid ourselves of it. In this paper, I argue against the orthodoxy by showing that the sunk cost effect is often beneficial. Drawing on discussions of related topics in dynamic choice theory, I show that, in a range of cases, being disposed to honor sunk costs allows an agent (...) to mimic a resolute chooser, someone who adopts the best plan at the outset of a decision problem and sticks with it, even when resoluteness is unfeasible. I discuss several kinds of cases in which honoring sunk costs coincides with resolute choice. (shrink)

Human interaction and communication involve space in multiple ways. This paper examines the spatial and interactional order of a covertly video-taped police interrogation. When the participants enter the interrogation room and become engaged in the interrogation process, the room itself is a constraint and a resource for interaction. While interacting within a built environment, the participants appropriate their material surroundings in ways that constitute a spatial order and make possible certain arguments. This paper examines how the physical structure of the (...) interrogation room is differentially appropriated, used, and filled in by the participants''; territorial and postural manoeuvers over the course of their interaction; and how the spatial structures thus created by the bodily appropriation of the physical locale are subsequently formulated by talk and thereby used as a metaphorical resource to frame the participants'' situated experience. Through this embedded process, the interrogators move the suspect toward confession. (shrink)

Heidegger and East-Asian thought have traditionally been strongly correlated. However, although still largely unrecognized, significant differences between the political and metaphysical stance of Heidegger and his perceived counterparts in East-Asia most certainly exist. One of the most dramatic discontinuities between East-Asian thought and Heidegger is revealed through an investigation of Kitarō Nishida’s own vigorous criticism of Heidegger. Ironically, more than one study of Heidegger and East-Asian thought has submitted that Nishida is that representative of East-Asian thought whose philosophy most closely (...) resembles Heideggerian thought. In words that then and now resound discordantly within the enshrined, established view of Heidegger’s relationship to East-Asian thought, Nishida stated uninhibitedly his own view of Heidegger in the noteworthy statement: “Heidegger is not worth your time… He…does not recognize that which is indispensible and decisive, namely, God.” This present study lays out for the first time in English, the significant differences between the metaphysical and political stances of Nishida and Heidegger, Nishida’s own critique of Heidegger, and Heidegger’s own rather dismal assessment of non-Western philosophy, all of which demonstrate a remarkable, hitherto unrecognized discontinuity between Heidegger and East-Asian thought. (shrink)